Case of the Month: February, 2012, Page 2

Explanation: 

• Certain forms of LCH can occur in infancy and belongs in the differential
• Neuroblastoma can be present at birth
• MNTI always occur in the first year of life.
• This patient is outside the bimodal peak incidences of rhabdomyosarcoma (2-5 and 15-19 years of age.)

Question: If this patient was found to have high urinary excretion of VMA what would be the most likely explanation of the radiographic findings?

1. Langerhans Histiocytosis
2. Metastatic Neuroblastoma
3. MelanoticNeuroectodermal Tumor of Infancy